CISummit 2013: Nicholas Christakis, Using Social Networks and Social Influence to Affect the Behavior of Physcians
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CISummit 2013: Nicholas Christakis, Using Social Networks and Social Influence to Affect the Behavior of Physcians
- 1. Social Network Interventions! Nicholas A. Christakis, MD, PhD! Human Nature Lab! Yale Institute for Network Science! Yale University! Twitter: @NAChristakis!
- 2. Network Interventions Human Networks Have a Consistent Structure!
- 3. Network Interventions Observations and Experiments on Social Contagion! Obesity! Smoking! Drinking! Drug Use! Happiness! Loneliness! Depression! Altruism! Sleep! Exercise! Purchases! Ideas!
- 6. Network Interventions Connections Matter! source: Brian Uzzi!
- 7. Network Interventions Intervening in Social Networks! Connection: changing the structure! ! ! Contagion: changing the flows !
- 8. Network Interventions Manipulating Connection! ONLINE NETWORK! RANDOM! NEIGHBORHOOD! D. Centola, “The Spread of Behavior in an Online Social Network Experiment,” Science 2010; 329: 1194-1197!
- 9. Networks & Evolution Cooperation! and Re-Wiring! EXPERIMENTS! Fluid! Fixed! Round! 1! 2! 6! 10! D. G. Rand, S. Arbesman, and N.A. Christakis, “Dynamic Social Networks Promote Cooperation in Experiments with Humans,” PNAS 108: 19193-19198 (2011)
- 10. Network Interventions Manipulating Contagion! EXPERIMENT 1: RANDOM PEOPLE! PEER EFFECTS UNDER CONTROL!
- 11. Network Interventions Manipulating Contagion! EXPERIMENT 2: CENTRAL PEOPLE! PEER EFFECTS UNDER ACCELERATION!
- 15. Network Interventions Network Targeting! VITAMINS IN HONDURAS! 1.0! ! 0.8! Mean proportion of coupons redeemed! ! 0.6! ! 0.4! nominated, 9 villages: 0.8 in-degree, 9 villages: 0.7 random, 7 villages: 0.66 ! 0.2! ! 0.0! 0! 2! 4! 6! 8! Day! 10! 12! 14!
- 18. Network Interventions Physician! Networks! BOSTON HOSPITALS! B.E. Landon, N.L. Keating, M.L. Barnett, J.P. Onnela, S. Paul, A.J. O’Malley, T. Keegan, and N.A. Christakis, “Variation in Patient-Sharing Networks of Physicians Across the United States,” JAMA 2012; 308: 265-273 !
- 19. Network Interventions Physician Networks! M. Barnett, N.A. Christakis, A.J. O’Malley, J.P. Onnela, N.L. Keating, and B. Landon, “Physician PatientSharing Networks and the Cost and Intensity of Care in US Hospitals,” Medical Care 2012; 50: 152-160!
- 20. Network Interventions Physician! Networks! HOSPITAL SPENDING! M. Barnett, N.A. Christakis, A.J. O’Malley, J.P. Onnela, N.L. Keating, and B. Landon, “Physician PatientSharing Networks and the Cost and Intensity of Care in US Hospitals,” Medical Care 2012; 50: 152-160!
- 21. Network Interventions Physician! Networks! JANUVIA PRESCRIPTIONS! 40 – 57 shared patients! 58 – 106 shared patients! 107+ shared patients! ! did not use Januvia! used Januvia! ! 0 – 57 prescriptions! 58 – 328 prescriptions! 329+ prescriptions! Source: www.ActivateNetworks.net!
- 22. Prescribers of Statins, 2009 ! Adop%ng Crestor + Generics Source: www.ActivateNetworks.net!
- 23. Prescribers of Statins, 2012 ! Adop%ng Crestor + Generics Source: www.ActivateNetworks.net!
- 24. Overall Change in Market Share ! Lipitor Crestor Generics Source: www.ActivateNetworks.net!
- 25. Community Differences ! Various colors indicate different communities Source: www.ActivateNetworks.net!
- 26. Influencers Make the Difference January 2009 January 2012 Source: www.ActivateNetworks.net!
- 27. Influencers Make the Difference January 2009 January 2012 Source: www.ActivateNetworks.net!
- 28. Network Interventions Network Effects! ENHANCING BEHAVIORAL INTERVENTIONS! Deliberately Creating Spillovers! ! Deliberately Exploiting Peer Reinforcement!
- 30. Network Interventions Your Hospital Physician! Networks! HOSPITAL LEAKAGE! Edge thickness represents number of patients Source: www.ActivateNetworks.net!
- 31. Network Interventions Physician! Networks! TYPES OF PHYSICIAN BEHAVIOR! Loyal In Scattered Loyal Out The physician shown here is sending patients to your hospital only. These are the physicians to reward and use as models. The highlighted physician is sending patients to multiple different hospitals. This behavior is likely to be patient-driven. This physician is sending all of his patients to one hospital that is not your own. This behavior is likely to be physician-driven. Source: www.ActivateNetworks.net!
- 32. Network Interventions Natural! Network! VARIATION IN POSITION!
- 34. Network Interventions DAILY INCIDENCE OF CONTAGION CUMULATIVE INCIDENCE OF CONTAGION Theoretical Differences in Epidemic Curves! TIME TIME NA Christakis and J H Fowler, “Social Network Sensors for Early Detection of Contagious Outbreaks” PLoS One, 5(9): e12948 !
- 35. Network Interventions 0.0004 0.0000 DAILY INCIDENCE OF INFLUENZA 0.0012 0.0008 0.06 0.42 0.02 0.00 CUMULATIVE INCIDENCE OF INFLUENZA 0.08 Observed Differences in Epidemic Curves! 0 20 40 60 80 100 DAYS SINCE SEPTEMBER 1 120 0 20 40 60 80 100 120 DAYS SINCE SEPTEMBER 1 NA Christakis and J H Fowler, “Social Network Sensors for Early Detection of Contagious Outbreaks” PLoS One, 5(9): e12948 !
- 37. Network Interventions Forecasting Drug Adoption in Physician Networks! Average % Adoption 30% Central 20% 10% Forecasting Capability! 0% 1 3 5 7 9 11 13 15 Months 17 19 21 23 25 27
- 38. Network Interventions Computational Social Science! PERVASIVE DATA! Internet (social networks, websites, links, etc.)! Telephony! Video cameras in cities! RFID devices! Administrative records (e.g., physician visits, crimes)! Transaction records! Geographic information! Voluntary losses of anonymity (data wikis)! Personal genetics!
- 39. Network Interventions Tyco Brahe (1546-1601)!